HomeMy WebLinkAboutWTR2702173 W-2173 Maplewood Golf Course Clubhouse 1
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FILE TITLE
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WHEN kte RDED RETURN TO Pvij 'i Fitt F-- --
OnneofEhefitrCkrk --
Rem,m Mankind Ruibiny Gnntogs)name _
?na Min Avew SSvth STREET INTEW7&6ION ti,of aD N .'
R.•mm,WA"1.1 NAME OF PRO)5cl'
�A�d.17Y r
BILL OF SALE
KNOW ALL MEN BY THESE PRESENTS: That the CITY OF RENTON of the County of DING,
State of Washington,the party of the first pan, for and in consideration of the sum of ONE and NO/100
Dollars lawful money of the United States of America,to THEM in hand paid by the party of the second
pan,the receipt whereof is hereby acknowledged,does by these presents grant,bargain,sell and deliver
unto the said party of the second part,the following described personal property now located at 4000
Q MAPLE VALLEY HIGHWAY in the City of RENTON,County of ICING and State of Washington,to-
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p See Attached Exhibit"A". `PROJECT CLOSING FINAL COST DATA AND INVENTOR=
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TO HAVE AND TO HOLD the same to the said patty of the second pan,their heirs exwutors g a +-
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administrators and assigns forever. And said party of the first pan, for[heir heir,exavtors, ~<i
administrators,covenants and agrees to and with the said party of the sarond pan,their executors,
administrators and assigns,that said patty of the first pan is the owner Of the said property,goods and
chattels and has good right and PoII authority to sell the same,and that they will warrant and defend the
sale hereby made unto the said patty of the second part,their exavtors,administrators and assigns,
against all and every person or persons,whomsoever,lawfully claiming or to claim the same,
IN WITNESS WHEREOF,The said party of the first pan has hereunto set their hand and seal
this 21th day of February.1996.
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STATE OF WASHINGTON )
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COUNTY OF KING )
1 cenify that I know or hase satisfactory evidence that LCs_bgA.—&ILh is the person who
x appeared before me and said person acknowledged that(he/she)signed this instrument and acknowledged
it to be(his/her)free and voluntary act for the uses and pugases mentio ted in the instrument.
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g Dated: ?i Feb 11V
Notar Puhlic in' rd for the Slate of Washington
No rN(Prin04/,M .SZ�_LAgn)S_ —
arvc,�6osPoRM.DOC&W5M �jb-Co31 My apla)intment expires:_/o
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PROJECT CLOSING 06 Final c.MDina
FINAL COST DATA AND INVENTORY fa4Ltew a
511111('I Maalrwood Golf Count CnY PRO)FCT NI IMIWRS WI'R. Z /
WW\'-
Site Work for(luhhouw !I Drtyial R,q r SWP-
I'P 11
to 01,el Rotor IRt1M City of Rmmn
1'IMi Harmr S.tvrm (_ummunir;Ren'laer D094 r
Plana... lwMnif/I`oh11c Weak. 260 Mlll A.rnw Smith 1
210 Mill Axcnic Mmlh W7 .W A yR•k{,A
HMtIMi.'AA YWA5 DAI'1. Fehruen A 1Af6
Per the request of the City of Rattai,the following infonnatim a famished cmcerting final costs for irtlproxemencs installed
for the above referenced ptged
WAITS SYSIYM CONS]RUC C(kti IN '
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PIAN''NWG/BUBDING/PUBLIC WORKS DEPARTMENT
Water Utility Engineering 235-2631
Municipal Building 200 Mill Ave.S.Renton,WA 98055
BACKFLOW DEVICE TEST REPORT
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Air Gap Inspection: Required minimum air gap wpmuon provided O w on.
Remarks:
1He A�•h REPORT is aZ[tT6ffD To Re TRI re
Return Report to m OR pRL b NAME' P n<N=o r.
Tom Malpllrus,Cross /� i'�
Connenuon Control Specialist 1Pay cen No. Ou<
Plannmg/Building/
Public Works Department arrAiPEu ev Cen No. ate
Water Utility Division _
200 Mill Avenue South I'Ln�v cen N . O..e
Renton,Washington 98055
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REQUEST FOR PROJECT N Path,PW (PP/ )
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From Plan Review/pro/ea Mmager
Pro/cu Name
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Circle Sire of Sewtthne. a" 10" 12" q —�
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WATER BACTERIOLOGICAL ANALYSIS
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Backflow Prevention Assembly Test Report
Name Maplewood Golf Course Custcode APLE
Service Address -43ppegERenton-Msp1e-VWtey Renton WA 98058 "I 1 b 1995
Contact Hpoo �1� vap•r ,tWy ''
Title = riENTON
Telephone . .rmg Dept
Assembly Information
Location: UNDER BEVERAGE MACHINE IN KITCHEN
Type of cross connection protected. CARBONATED BEVERAGE DISPENSER File#NEW
Type RPBA Manufacturer WATTS Serial#31703 Size 0.500 Model 009QT
In;'ial Test Results Test Date 10/13/95 Line Pressure: 45
Pressure drop across 1st check 9.25
First Check: Closed tight Relief valve opens at 4 psid
Second Check: Closed tight
Repairs made: No repairs done
Comments.
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This Backflow Prevention .Assembly passed required testa y
City of Renton•Water Dept. Test�d mo j8*ag_go,�
200 Mill Ave. South BAT# 1513
Renton, WA 98055 23827 24th. Dr. SE
Bothell, WA 98021
Alin: Cross Connection Control Department (206)2364474
i This lest pedameG nitha WWN Vfelenl:al pressure pau TK 99E SetlaI 000163531mmt taliNate0111119
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Backflow Prevention Assembly Test Report
Name Maplewood Golf Course Custcode MAPLEWOOD
Service Address 11-3090.,SE Renton,Maple Afelley Renton WA 98058
Contact y,co n .pl' v-1t.1 till
Title
Telephone
Assembly Information
Location: IN MECHANICAL ROOM NEAR KITCHEN -
Type of cross connection protected: SUPPLY FOR FOUNTAIN AND SWAMP File#NEW
Type RPBA Manufacturer WATTS Serial#34180 Size 0.500 Model 009OT
Initial Test Results: Test Date 10/13195 Line Pressure: 45
First Check: Leaks
Repairs made CLEANED DEBRIS FROM 1ST CHECK .w
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Re-test Results: Re-test date 10/13195 Line Pressure. 45
Pressure drop across first check. 8.5
First Check: Closed Tight Relief valve opens at 4.5 psid
Second Check. Closed Tight
Comments:
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This Backflow Prevention Assembly passed required tes
City of Renton-Water Dept. Tested agg
200 Mill Ave. South BAT# 151
Renton,WA 98055 23827 24th. Dr. SE
Bothell,WA 98021
Attn: Cross Connection Control Department (206)2364474
TNa lest pellot l mus a Wads ddrere,aw preswe gauge'rK.WE Send NMI 635 last cakre1w 11111414
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Backflrw Prevention Assembly Test Report
Name Maplewood Golf Course Custcode MAPLEWOOD
Service Address 43020. E enton.Maple-Valley Renton WA 98058
Contact 'two rei,-O' v4N,y t+"y
Title
Telephone
Assembly Information
Location: UNDER BAR NEXT TO DISHWASHER
Type of cross connection protected CARBONATED BEVERAGE DISPENSER File#NEW
Type RPBA Manufacturer WATTS Serial# 33194 Size 0.500 Model 0090T
Initial Test Results! Test Date 10113195 Line Pressure: 45
Pressure drop across 1 st check 9
First Check: Closed tight Relief valve opens at 4 psid
Second Check: Closed tight u
Repairs made: No repairs done
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Comments:
This Backflow Preventicn Assembly passed required t� ff 1 x
City of Renton-Water Dept Tested By'T6m Baage
200 Mill Ave. South BAT# 15
23b27 24th. Dr. SE
Renton,WA 98055 Bothell, WA 98021
Attn: Cross Connection Control Department (206)236A474
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Backflow "revention Assembly Test Report
Name Maplewood Golf Course Custcode MAPLEWOOD
Service Address a}p2pgE-RentaTf"Nfa te-Veller Renton WA 98058
Contact y000 m.P c vut �y ttW y
Title
Telephone
Assembly Information
Location: IN KITCHEN UNDER STEAMER
Type of cross connection protected. FEED TO STEAMER File#NEW
Type DCVA Manufacturer WATTS Serial#D1829 Size 0.500 Model 0070T
Initial Test Results: Test Date 10/13/95 Line Pressure: 45
First Check: Closed tight
Second Check: Closed tight
Repairs made: No repairs done
comments
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This Backflow Prevention Assembly passed required tes��
City of Renton -Water Dept Teslatl TOm Bagg
200 Miil Ave. South BAT#15By:
23827 241h. Dr. SE
Renton, WA 98055 Bothell, WA 98021
Alin. Cross Connection Control Department (206)236-4474
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PLANNING/BURDPIG/PUBLIC WORKS DEPAR774IIVT
F4 Water Utility
Engineering 235-2631 rRe V' Nally 604unlcipal Budding 200 MW Ave.S.Renton,WA 98055
y 1A-el-Vekla-y 0-"'BAMFLOW DEVICE TEST REPORT
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Remarks:
r�akwva Rasoar n�ry aantua_
Return Report to OR PRINIFD NAME !Rode NuWiv
Tom Malphrus,Cross -"e
Connection Control Specialist i
Plannmg.Building/ -
Public W utia Department RJTA sv: ern No. DR.e
Water.Utility Division
200 MW Avenue South rrsr?r'.� cm Dee d..-
Renton,Washington 98055 IT- -iJ
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RACM(m Dmcl TEST RE.ORT
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